Lung Clearance Index is a Repeatable and Sensitive Indicator of Radiological Changes in Bronchiectasis.

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Abstract

Rationale In bronchiectasis there is a need for improved markers of lung function to determine disease severity and response to therapy. Objectives To assess if lung clearance index is a repeatable and more sensitive indicator of CT scan abnormalities than spirometry in bronchiectasis. Methods Thirty stable bronchiectasis patients were recruited and lung clearance index, spirometry and health related quality of life measures were assessed on two occasions, two weeks apart when stable (study 1). A separate group of 60 patients with stable bronchiectasis were studied on a single visit with the same measurements and a CT scan (study 2). Measurements and main results In study 1, the inter-visit intraclass correlation coefficient for lung clearance index was 0.94 (95% CI 0.89 to 0.97, p<0.001). In study 2, mean age was 62 (10) years, FEV1 76.5 % predicted (18.9), lung clearance index 9.1 (2.0) and total CT score 14.1 (10.2) %. Lung clearance index was abnormal in 53/60 patients (88%) and FEV1 was abnormal in 37/60 (62%). FEV1 negatively correlated with lung clearance index (r=-0.51, p<0.0001.) Across CT scores, there was a relationship with lung clearance index, with little evidence of an effect of FEV1. There were no significant associations between lung clearance index or FEV1 and health related quality of life. Conclusions Lung clearance index is repeatable and a more sensitive measure than FEV1 in the detection of abnormalities demonstrated on CT scan. Lung clearance index has the potential to be a useful clinical and research tool in patients with bronchiectasis.

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